抗生素假期在2阶段交换为周围假肢关节感染:一个范围审查
Andrew Fraval1, Daniel Gould2, Mehmet Kursat Yilmaz3
1Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Australia.
概括
抗生素假期在治疗周围假肢关节感染 (PJI) 中没有被证明比两阶段交换关节整形更优越. 这种做法可能会不必要地延长治疗时间,而不会改善结果.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 手术创新 在外科创新.
背景情况:
- 双阶段交换关节整形手术是对周围假肢关节感染 (PJI) 的常见策略.
- "抗生素假期"通常在阶段之间用于确认感染清除,但证据有限.
- 本综述系统地检查了PJI管理中的抗生素假期的文献.
研究的目的:
- 系统地绘制有关抗生素假期的文献,为慢性PJI进行两阶段的修订.
- 为了确定抗生素假期是否在为PJI进行两阶段交换关节整形手术的患者中发挥作用.
主要方法:
- 进行了符合PRISMA系统审查和元分析 (PRISMA) 的优先报告项目范围审查.
- 从2579个标题和摘要中提取数据,其中包括243篇全文文章.
- 用描述性分析来分析数据.
主要成果:
- 大多数研究 (97.9%) 是病例系列; 84.9% 使用了抗生素假期.
- 与持续治疗 (13.1%) 相比,抗生素假期组 (16.4%) 的治疗失败率更高.
- 使用连续治疗的研究与使用抗生素假期 (27.2%对66.7%) 的研究相比,阶段间的间隔较短 (<3个月).
结论:
- 在慢性PJI的两阶段交换中,没有证明抗生素假期的好处.
- 抗生素假期可能会导致不必要的治疗延长而没有改善的结果.
- 在PJI管理中使用抗生素假期的做法需要进一步基于证据的评估.
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